scholarly journals Prospective Study of Fertility Preservation in Young Women With Breast Cancer in Mexico

2021 ◽  
pp. 1-8
Author(s):  
Cynthia Villarreal-Garza ◽  
Fernanda Mesa-Chavez ◽  
Alejandra Plata de la Mora ◽  
Melina Miaja-Avila ◽  
Marisol Garcia-Garcia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Supportive Care ◽  
Fertility Preservation ◽  
Young Women ◽  
Young Patients ◽  
Young Group ◽  
Embryo Cryopreservation ◽  
Resource Constrained ◽  
Chi Square ◽  
Patient Reported

Background: Despite the risk of treatment-related infertility, implementation of fertility-preservation (FP) strategies among young patients with breast cancer is often suboptimal in resource-constrained settings such as Mexico. The “Joven & Fuerte: Program for Young Women With Breast Cancer” strives to enhance patient access to supportive care services, including FP measures through alliances with assisted-reproduction units and procurement of coverage of some of these strategies. This study describes patients from Joven & Fuerte who have preserved fertility, and assesses which characteristics were associated with the likelihood of undergoing FP. Methods: Women aged ≤40 years with recently diagnosed breast cancer were prospectively accrued. Sociodemographic and clinicopathologic data were collected from patient-reported and provider-recorded information at diagnosis and 1-year follow-up. Descriptive statistics, chi-square test, and simple logistic regression were used to compare patients who preserved fertility with those who did not. Results: In total, 447 patients were included, among which 53 (12%) preserved fertility, representing 38% of the 140 women who desired future biologic children. Oocyte/embryo cryopreservation was the most frequently used method for FP (59%), followed by temporary ovarian suppression with gonadotropin-releasing hormone agonists (GnRHa) during chemotherapy (26%), and use of both GnRHa and oocyte/embryo cryopreservation (15%). Younger age, higher educational level, being employed, having private healthcare insurance, and having one or no children were associated with a significantly higher likelihood of preserving fertility. Conclusions: By facilitating referral and seeking funds and special discounts for underserved patients, supportive care programs for young women with breast cancer can play a crucial role on enhancing access to oncofertility services that would otherwise be prohibitive because of their high costs, particularly in resource-constrained settings. For these efforts to be successful and widely applied in the long term, sustained and extended governmental coverage of FP options for this young group is warranted.

Sexual function and satisfaction in Mexican young women undergoing breast cancer treatment.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21714-e21714
Author(s):  
Cynthia Mayte Villarreal-Garza ◽  
Alejandra Platas ◽  
Andrea Castro-Sanchez ◽  
Melina Miaja ◽  
Alan Fonseca ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sexual Function ◽  
Young Women ◽  
Young Patients ◽  
Study Data ◽  
Mexican Women ◽  
Chi Square ◽  
Younger Women ◽  
Chi Square Test

e21714 Background: Compared to other regions, the burden of breast cancer (BC) in Mexico is disproportionately borne by younger women. Yet, their particular needs and concerns have remained understudied, including treatment-related sexual adverse effects. We aim to assess the sexual function and satisfaction in Mexican young women with BC undergoing treatment. Methods: This is a prospective sexual assessment study in BC patients of the pilot phase of the Joven y Fuerte Mexican cohort (N=96). Sexual health was assessed using the Female Sexual Function Index (FSFI) and the Sexual Satisfaction Inventory (SSI) at two points in time: baseline (BL) and 6-months follow-up (6-FU). FSFI and SSI scores lower than 26.55 and 111, respectively, were defined as sexual morbidity. Differences between proportions of BL and 6-FU were examined with Pearson chi-square test. Matched t-tests were used to test for differences in the domains of the FSFI and in the SSI total score. Results: 70 women completed the FSFI at both time points and 69 the SSI. Our results showed a high percentage of sexual dysfunction among Mexican women at BL and 6-FU (61.4% and 74.3%, respectively, p<0.001), as well as an elevated proportion of sexual low satisfaction at both time lines (40.6% and 43.5%, p=0.004). Most 6-FU FSFI domain scores were significantly worse than those at BL (Table 1). There were no significant differences in the SSI total score (102.31 [BL] vs 96.11 [6-FU], p=0.16). Conclusions: Mexican young patients with BC report significant sexual morbidity at BL, which even worsens after the first short follow-up. Reasons for the low sexual performance among Mexican women remain understudied and should be actively sought. In this prospective study, data will be annually collected for five years. This information will provide valuable information in an often-neglected matter of BC patients’ care. [Table: see text]

P–457 Emergency fertility preservation (FP) in female patients- utilisation rate of the stored eggs/embryos and pregnancy outcomes

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
V Balakumar ◽  
S C Khaw ◽  
P Milne ◽  
S Kini
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Survival Rate ◽  
Fertility Preservation ◽  
Young Women ◽  
Pregnancy Outcomes ◽  
Cancer Survival ◽  
Embryo Cryopreservation ◽  
Utilisation Rate ◽  
The Mean

Abstract Study question The aim of the study was to determine the percentage of patients returning to use their stored eggs/embryos following FP and their pregnancy outcomes. Summary answer The patient utilisation rate for eggs/embryos was 17% with a live birth rate of 59%. What is known already Fertility preservation is considered as a vital issue for individuals in the reproductive stage of life when their future fertility may be compromised. Increased cancer survival rate and advances in assisted reproductive techniques make this an essential service to offer to patients facing life limiting disease or long-term medical conditions.FP is important to improve the quality of life in cancer survivors. Study design, size, duration A retrospective analysis was performed over a period of ten years between January 2010 to December 2020 in our tertiary unit. A total of 75 patients who underwent FP were identified. Participants/materials, setting, methods Infertility database for embryology and andrology (IDEAS) was used for the data collection and analysis. Patient’s age, reasons for fertility preservation, type of benign/cancer condition, protocol used for controlled ovarian stimulation (COS), dose of the gonadotropins, number of eggs collected, number of eggs/embryos cryopreserved, duration between storage and fertility treatment, pregnancy outcomes were included in the analysis. Main results and the role of chance Seventy-five patients underwent FP during the 10-year study period. The mean age was 30 years (range 17–43). Seventy-two patients (96%) underwent treatment for oncological reasons and the rest (4%) were for gender transition and Crohn’s disease. The most common types of malignancies include breast cancer (36%), Hodgkin’s lymphoma (18%) and cervical cancer (15%). Ninety-two percentage of patients underwent COS with an antagonist cycle, with an average of 10.8 eggs collected. Recombinant follicle stimulating hormone (FSH) was used in 92% of the cycles and human menopausal gonadotropin (HMG) was used in 8%. Fifty-eight percentage were given a maximum dose of 300IU of gonadotropin. The mean yield of eggs was higher in patients with breast cancer (12.62) followed by Hodgkin’s (10.5) and cervical cancer (9.6). Majority (60%) had embryo cryopreservation (82% at blastocyst stage and 18% at day 3 cleavage stage) and the rest (40%) had egg cryopreservation. A total of 17% (12) of patients returned for treatment with a livebirth rate of 59% and miscarriage rate of 8%. One third of livebirths were achieved through surrogacy. The average duration between fertility preservation and return for treatment was 2.4 years. Limitations, reasons for caution During the last 5 years, there has been an increase in the number of young women requiring FP in our unit. These women may require a considerable amount of time to complete their oncological treatment before embarking on pregnancy using their stored eggs/embryos. Wider implications of the findings: As cancer survival rate improves, there will be a likely increase in the utilisation rate for follow up treatment among young women who had FP. The overall awareness of the gonadotoxic effect of cancer therapy and available fertility preservation options among both patients and clinicians needs to be increased. Trial registration number NA

The importance of fertility preservation in women with early breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20663-e20663
Author(s):  
A. Agbarya ◽  
S. Linn
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Young Women ◽  
Large Scale ◽  
Breast Cancer Survivors ◽  
Early Stage ◽  
Young Patients ◽  
Future Research ◽  
Medical Procedure ◽  
Young Breast Cancer

e20663 Background: Young women with breast cancer often seek advice regarding treatment effects on their fertility. The purpose of this study was to gain a better understanding of women's attitudes to fertility and how these concerns affect decision-making. Methods: A survey on fertility issues was developed for young women with a history of early-stage breast cancer. The survey was completed by direct interviews with the patients. Results: Eighty-four eligible respondents completed the survey. Mean age at breast cancer diagnosis was 34.7 years. Fifty-seven percent of the women were Jewish and 43% were Arabic; 71% were married; 75% had more than 12 years of education. Stages at diagnosis were: I - 51%; II - 38%; III - 11%. Seventy-seven percent of the women were within six months of diagnosis and 49% reported substantial concern about becoming infertile with treatment. In multivariate logistic regression, a greater concern about infertility was associated with a wish for children (p=0.0008), number of children less than three (p=0.001), more than 12 years of education (p=0.004), and a moderate or high level of fear of treatment (p=0.004). Seventy-nine percent of patients reported discussing fertility concerns with their doctors, and 14% underwent a medical procedure for fertility preservation. Only five patients stated that infertility concerns influenced their treatment decisions. Conclusions: 1. Fertility after treatment is a major concern for young breast cancer patients undergoing chemotherapy. 2. This statement was not affected by ethnicity. 3. There is a need to communicate with and educate young patients regarding fertility issues and large scale future research directed at preserving fertility for young breast cancer survivors is warranted. No significant financial relationships to disclose.

scholarly journals Value of Early Referral to Fertility Preservation in Young Women With Breast Cancer

2010 ◽  
Vol 28 (31) ◽  
pp. 4683-4686 ◽  
Author(s):  
Sanghoon Lee ◽  
Sinan Ozkavukcu ◽  
Elke Heytens ◽  
Fred Moy ◽  
Kutluk Oktay
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Young Women ◽  
Breast Surgery ◽  
Secondary Analysis ◽  
Group Versus ◽  
Oocyte Retrieval ◽  
Embryo Cryopreservation ◽  
Early Referral ◽  
Patients With Cancer

Purpose To determine whether early referral to reproductive specialists improves fertility preservation (FP) outcomes and reduces delay in adjuvant treatment in young women with breast cancer. Patients and Methods A secondary analysis of a prospective database of patients with breast cancer undergoing ovarian stimulation (OS) for FP by oocyte or embryo cryopreservation was performed. Results Of the 154 patients, 93 met the inclusion criteria (mean age, 35.2 ± 4.4 years). Thirty-five of the 93 patients were referred before breast surgery (PreS), and 58 patients were referred after surgery (PostS). The time periods from initial diagnosis (ID) to initiation of OS (42.6 ± 27.7 days for PreS v 71.9 ± 30.7 days for PostS; P < .001) and from ID to initiation of chemotherapy (83.9 ± 24.3 days for PreS v 107.8 ± 42.9 days for PostS; P = .045) were significantly shorter for the PreS group versus the PostS group. Nine (25.7%) of 35 patients in the PreS group versus one (1.7%) of 58 patients in the PostS group were able to undergo two FP cycles (P < .001), resulting in an increased yield of oocytes in the PreS group (18.2% [93 of 511 oocytes] v 0.6% [five of 800 oocytes], respectively; P < .001) and embryos (17.2% [40 of 233 embryos] v 0.6% [two of 357 embryos], respectively; P < .001). Patients who had an oocyte retrieval within 5 weeks of the surgery were able to complete a second cycle within 9 weeks of the surgery. Conclusion FP referral before breast surgery enables earlier initiation of cryopreservation cycles and chemotherapy and, when appropriate, multiple FP cycles. Women who can undergo multiple cycles may be at advantage for FP because of a larger number of oocytes or embryos cryopreserved. This is the first study demonstrating the benefit of early FP referral in patients with cancer.

scholarly journals Amenorrhea, fertility preservation, and counseling among young women treated with anthracyclines and taxanes for early-stage breast cancer, a retrospective study

Medicine ◽  
2020 ◽  
Vol 99 (11) ◽  
pp. e19566 ◽  
Author(s):  
Hikmat N. Abdel-Razeq ◽  
Razan A. Mansour ◽  
Khawla S. Ammar ◽  
Rashid H. Abdel-Razeq ◽  
Hadil Y. Zureigat ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Fertility Preservation ◽  
Young Women ◽  
Early Stage ◽  
Early Stage Breast Cancer

Young, Empowered and Strong: A Web-Based Education and Supportive Care Intervention for Young Women With Breast Cancer Across the Care Continuum

2021 ◽  
pp. 933-943
Author(s):  
Tal Sella ◽  
Craig Snow ◽  
Hannah Freeman ◽  
Philip D. Poorvu ◽  
Shoshana M. Rosenberg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Breast Cancer Survivors ◽  
Metastatic Breast ◽  
Patient Reported Outcome ◽  
Self Management ◽  
Semistructured Interview ◽  
Web Based ◽  
Care Continuum ◽  
Patient Reported

PURPOSE Patient-centered digital interventions may help empower young women to self-manage symptoms and psychosocial concerns and support informational needs often unaddressed in clinic. METHODS Young, Empowered and Strong (YES) is an interactive web-based intervention designed to engage young women with personalized education and symptom self-management resources on the basis of responses to patient-reported outcome–based questionnaires. We piloted YES among young women (< 45 years) with newly diagnosed early breast cancer (EBC) or metastatic breast cancer (MBC) and breast cancer survivors (BCSs). Assessments were deployed weekly (EBC and MBC) or every 4 weeks (BCSs) over 12 weeks. At study completion, use, feasibility, and acceptability of YES were evaluated via a survey and semistructured interview. RESULTS Thirty women were enrolled between April and June 2019: 10 EBC, 10 BCSs, and 10 MBC. The mean age at diagnosis and enrollment was 36 (range 25-44) and 39 (range 31-44) years, respectively. Most participants were actively treated (96%, 27 of 28) with endocrine therapy (54%, 15 of 28) or chemotherapy (43%, 12 of 28). Overall, 61% (180 of 296) of assessments were completed (EBC: 70%, BCSs: 63%, and MBC: 52%). Of 37 patient-reported outcome and need domains, the most frequently triggered were sexual health (EBC: 90%, BCSs: 90%, and MBC: 90%), anxiety (EBC: 80%, BCSs: 90%, and MBC: 90%), stress and mindfulness (EBC: 80%, BCSs: 90%, and MBC: 90%), and fatigue (EBC: 90%, BCSs: 80%, and MBC: 90%). On postpilot survey, participants reported that YES helped them to learn (50%, 7 of 14), monitor (43%, 6 of 14), and manage (57%, 8 of 14) their symptoms. CONCLUSION YES is a feasible and acceptable digital intervention to support young women across the breast cancer care continuum. The nearly universal triggering of sexual and mental health needs suggests suboptimal management in the clinical setting and the potential for self-management through a digital platform.

scholarly journals Real-World Data Related to Non-Metastatic Breast Cancer in Young Women: Experience of a Single Institution

2018 ◽  
Vol 64 (1) ◽  
pp. 45-53
Author(s):  
Juliana Cunha e Silva Ominelli De Souza ◽  
Andrew Sá Nunes ◽  
Jesse Lopes Da Silva ◽  
Aline Coelho Gonçalves ◽  
Suzanne Crocamo Ventilari Da Costa
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Lymph Node ◽  
Young Women ◽  
Advanced Disease ◽  
Young Patients ◽  
Metastatic Breast ◽  
Lymph Node Involvement ◽  
Axillary Lymph ◽  
Node Involvement

Introduction: Breast cancer is the leading cause of cancer-related deaths in women aged 20-59 years. Younger women usually have more aggressive tumors and more advanced disease with larger size and axillary lymph node involvement. There have been few studies assessing the characteristics of breast cancer in very young women. Objective: Evaluate the epidemiological and clinical profile of non-metastatic very young patients with breast cancer. Method: We performed a retrospective analysis to evaluate the epidemiological and clinical profile of non-metastatic breast cancer in patients ≤ 30 years of age treated between 1993 and 2011 at the Brazilian National Cancer Institute José Alencar Gomes da Silva. We evaluated relapse-free survival (RFS) and overall survival (OS). Results: Of the 196 patients evaluated, 181 (90%) had ductal carcinoma, 79 (40%) had high-grade tumors, and 102 (52%) had hormone receptor-positive tumors. 117 patients(60%) had stage III disease at diagnosis. The median age was 29 years (range, 17-30 years). Of 185 patients who underwent surgery, 156 (84.3%) underwent total mastectomy and 171 (92%) underwent axillary lymph node dissection. 119 patients received neoadjuvant chemotherapy, and 14 patients (9.3%) underwent neoadjuvant radiotherapy. After a median follow-up of 81.5 months, 109 patients (55%) had relapsed and 81 (41%) had died. The median RFS and OS were 49.5 months and 134 months, respectively. Lymph node involvement and neoadjuvant chemotherapy were associated with shorter RFS and OS. Conclusion: Breast cancer is uncommon in young patients, especially in those ≤ 30 years of age. We found a predominance of locally advanced disease and worse prognostic pathological characteristics. Despite the aggressive treatment, our patients had worse outcomes than those reported by other authors.

Sign in / Sign up

Export Citation Format

Share Document